4/1 Minnie still in hospital - will get feeding tube tomorrow THANK YOU

Liz & Minnie

Liz & Minnie

Very Active Member
yesterday
Just talked to vet - this time internist looking after her instead of ER vet. Potassium still low, rising slowly. Waiting on blood work including lipid levels/affect of bezafibrate. Eating is "good" (scale is excellent/good/handfed/zero interest).

BG has been upper 200s so they gave no R but she had a hypo last night 4-5am and they gave her dextrose. Checking hourly with the Libre and she's currently low 150-160s. She will be there at least til tomorrow, discharge depends on potassium levels.

I need to make a decision on esophogeal feeding tube by this time tomorrow, I said not to do it today (they do it late afternoon and need to schedule around noon. I predict she will still be there tomorrow and maybe another day). Tube 'should' be temporary til we get her through this. I do not want her with a permanent tube, I worry about QOL.

Interested in hearing experience with esophogeal feeding tubes. @Suzanne & Darcy I know you mentioned it. I don't want her suffering. Vet said lots of patients do well with them. I asked what she would do if it was her cat and she said "I'd be thinking really hard" (a little helpful but not too much)

Thanks.
 
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I recall that @JL and Chip has some experience with feeding tubes, and there are others, I just can't seem to remember people more recently, and I'm just in between work calls at the moment, so I wanted to reply, apologies for being quick - I have done assist feeding myself, but not used a feeding tube, so I have no experience to share with that.

Here is Dr. Lisa's information page in the meantime, until you get some better responses. Sending extra healing vines for Minnie.

http://www.catinfo.org/?link=feedingtubes
 
Jax had an esophagostomy tube in 2018; in Jax's case we were battling a severe stomach ulcer and suspected sepsis. His tube was in for about 3 weeks but I only used it for feeding for about a week (I think we fed watered-down Hills A/D). After Jax started eating food on his own, I still pushed extra mls of water as well as his meds (one of which was his potassium supplement - he was hypokalemic too). The feeding tube definitely allowed me to get food (& meds!) in him and gave him energy to heal.

One other thing about the feeding tube decision is you don't want to wait too long as there needs to be anesthesia so the kitty needs to be stable enough for that.

Here's Jax eating with his Kitty Kollar which helped hold his e-tube in place.

Happy to answer any questions (if I can remember :)). Whatever decision you make is the right one :bighug: Hugs to you and Minnie :bighug:

jaxtube-jpg.57934
 
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JaxBenji said:
Jax had an esophagostomy tube in 2018; in Jax's case we were battling a severe stomach ulcer and suspected sepsis. His tube was in for about 3 weeks but I only used it for feeding for about a week (I think we fed watered-down Hills A/D). After Jax started eating food on his own, I still pushed extra mls of water as well as his meds (one of which was his potassium supplement - he was hypoklamic too). The feeding tube definitely allowed me to get food (& meds!) in him and gave him energy to heal.

One other thing about the feeding tube decision is you don't want to wait too long as there needs to be anesthesia so the kitty needs to be stable enough for that.

Here's Jax eating with his Kitty Kollar which helped hold his e-tube in place.

Happy to answer any questions (if I can remember :)). Whatever decision you make is the right one :bighug: Hugs to you and Minnie :bighug:

jaxtube-jpg.57934
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Oh Susanne, thank you so much for sharing your expertise at such a difficult time. I am so sorry to hear about poor little Jax, he sounds (and looks) like such a wonderful little guy. Can't tell you how much I appreciate you continuing to share, I can't imagine :bighug:.

I have been reading all about feeding tubes while waiting for opinions and I think I will do it, your info has convinced me. Just another scary thing that seems like a good idea once you get over the shock. She is in hospital already. Really the only benefit of doing today vs tomorrow is that it could potentially prolong her stay a few hours if it's tomorrow because they do it late afternoon...but I don't think they're going to have her potassium fixed tomorrow anyway. She is eating well so I figure another day gives her another day to get stronger anyway.

Was looking at kittykollar! Dr Lisa said she wasn't a fan - did you like it? I think she gets discharged with one - should I get more?

Oh, and any recommendation on tubes - I'm guessing different from syringe feeding tubes. Should I buy them and which did you like, or does the vet provide enough? My credit card is on fire right now.

That picture of little Jax makes me smile and tear up at the same time. Thank you so much again. :bighug::bighug:
 
Liz & Minnie said:
yesterday
Just talked to vet - this time internist looking after her instead of ER vet. Potassium still low, rising slowly. Waiting on blood work including lipid levels/affect of bezafibrate. Eating is "good" (scale is excellent/good/handfed/zero interest).

BG has been upper 200s so they gave no R but she had a hypo last night 4-5am and they gave her dextrose. Checking hourly with the Libre and she's currently low 150-160s. She will be there at least til tomorrow, discharge depends on potassium levels.

I need to make a decision on esophogeal feeding tube by this time tomorrow, I said not to do it today (they do it late afternoon and need to schedule around noon. I predict she will still be there tomorrow and maybe another day). Tube 'should' be temporary til we get her through this. I do not want her with a permanent tube, I worry about QOL.

Interested in hearing experience with esophogeal feeding tubes. @Suzanne & Darcy I know you mentioned it. I don't want her suffering. Vet said lots of patients do well with them. I asked what she would do if it was her cat and she said "I'd be thinking really hard" (a little helpful but not too much)

Thanks.
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Hi Liz. The esophageal feeding tube was a very brief surgery. It does not take them long to place the tube. They do it with imaging for correct placement. Darcy had no problems or complications with the tube. We were able to give him all of his food an medications through the tube, so it made everything super easy. I kept the tube in for one month, even though he really didn't need to keep it in that long because he began eating on his own (and they are not designed to be left in permanently). I believe the tube saved his life. He had been left to go too long without eating as it was and developed hepatic lipidosis.
 
Suzanne & Darcy said:
Hi Liz. The esophageal feeding tube was a very brief surgery. It does not take them long to place the tube. They do it with imaging for correct placement. Darcy had no problems or complications with the tube. We were able to give him all of his food an medications through the tube, so it made everything super easy. I kept the tube in for one month, even though he really didn't need to keep it in that long because he began eating on his own (and they are not designed to be left in permanently). I believe the tube saved his life. He had been left to go too long without eating as it was and developed hepatic lipidosis.
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Thank you. I still can't believe everything you and Mr Darcy have gone through. This is yet another convincing vote to go ahead with it. :bighug:
 
They can show you how to use it. It's not bad at all. Quite a small tube actually. I was surprised because I had a cat about 20 years ago who had a feeding tube and it was much bigger, bulkier and stuck up a lot higher.

Flush with a little water both before and after feeding to make sure food is not left stuck in the tube. I'm trying to think of everything....

Oh, you do need to check the incision site daily, which only means to unwrap the neck that has the self adhesive bandage on it. And change the dressing (non-stick pad) there. Then re-wrap the bandage. It's not hard to do.
 
They did his at night (really in the middle of the night at the emergency vet). They put him on a "slow feeding pump" that started by giving him very small amount of food through the tube. As soon as he started getting his nutrition through that tube, he started to improve. By the time I picked him up in the morning to do the daily run to the regular vet (because this particular emergency vet closes every day at 8 a.m. and then re-opens at 6 p.m.) he was really already perking up. I could notice a difference.
 
Suzanne & Darcy said:
I'm trying to think of everything....
.
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Thank you! You seem to have a LOT of sick kitty experience. The dr said they will provide instructions on the tube, no idea if they'll let me in or not to demonstrate. Other vets have. All I can do now is start ordering supplies on-line. How did people cope in the "old" days?!
 
Liz & Minnie said:
did you like it? I think she gets discharged with one - should I get more?
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I did like it - I also wasn't asked about it :p but it kept his tube out of the way. I didn't get any extra - though maybe one extra would be good and you could wash the other? Or just get her home and see (I didn't clean Jax's while he had...judge away lol...I also don't remember it being grimy or anything)

Liz & Minnie said:
Should I buy them and which did you like, or does the vet provide enough?
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My vet just gave me a couple - I washed them and reused. I think we had a couple for food and a couple for meds. If you have pills, the vet may provide instructions to crush the pill and put it in water in a syringe and then you shoot the mixture down the tube. This was fabulous IMHO.

Suzanne & Darcy said:
ou do need to check the incision site daily
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So I didn't have to check the stoma site? I'm not sure why (I also didn't have a lot of feline health knowledge back then). The vet just checked it at his follow-ups.

Suzanne & Darcy said:
Flush with a little water both before and after feeding to make sure food is not left stuck in the tube.
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Yes we did this too - water before and water after. I think we had instructions to use carbonated water if anything got stuck in the tube but we never had to do that.

Liz & Minnie said:
That picture of little Jax makes me smile and tear up at the same time. Thank you so much again. :bighug::bighug:
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you are so welcome - and please look at him in that pic and in my profile pic. He was so sick in that feeding tube picture...I think 9ish pounds...in my profile pic, he is 14.2 (his "regular" weight). Happy to help :bighug:
 
I am looking back over the text messages I had from teh ER Vet that night. Vet said it was a 10-20 minute procedure. So he only needed to be anesthetized for a very short time. They used the new (supposedly even safer than Propofol) anesthesia drug called Alfaxan.
 
Liz, there are a lot of videos on youtube about cat feeding tubes. It could be confusing though because there are different types.

They should give you a supply of the special syringes that thread onto the feeding tube. The have the "luer lock" tip. The feeding tube has a little cap on the end of it when you are not using it. Be sure to get an extra cap if you can.
 
As to weight gain. Darcy was only 12 lbs at the time of his sickness. He's 17 now. He was up to about 14.5 lbs. by the time we took the tube out a month later. They will tell you exactly how much to feed (in CCs) and exactly how many times per day to do it. I really think that the slow feeding pump was extremely important for the first few days though -- for a cat who had not been eating anything.
 
I never got the kittykollar... but I kind of wished I had... but then again I don't really know if it would have worked for us. I just bought a lot of that self-sticking wrap (they sell it on Amazon under different names... Vet Wrap is one of them... but I also found it at the drug store.

When Darcy had his feeding tube removed, they said it was just kind of barely hanging in there ... ready to come out.
 
Well.... they'd better let you in there wearing a mask or something to show you how to do this!! First, you take a syringe with a little water in it and screw it on to the end. Before you push the water into the syringe, you have to pull the plunger backwards a little and there should be negative pressure .... meaning that the plunger of the syringe should kind of suck back down. This is important because it tells you that the feeding tube is working and is still correctly placed. Then you go ahead and push the water into the tube. After this, unscrew the syringe and screw in the syringe that you have filled with the food an proceed with the feeding. After that, just flush with a little water to wash all the food from the tube.
 
Liz & Minnie said:
Thank you! You seem to have a LOT of sick kitty experience.
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Oh boy. I have a lot of sick kitty experience for sure! Ugh! Just today I've been at the vet with a kitten we just rescued. Poor thing had been injured somehow, had developed an abscess that burst. I left her at the vet this morning. Turns out that she had a bunch of maggots in there (I knew she smelled bad). Vet had to anesthetize her, clean it all out, etc. Poor baby.
 
Suzanne & Darcy said:
Well.... they'd better let you in there wearing a mask or something to show you how to do this!! First, you take a syringe with a little water in it and screw it on to the end. Before you push the water into the syringe, you have to pull the plunger backwards a little and there should be negative pressure .... meaning that the plunger of the syringe should kind of suck back down. This is important because it tells you that the feeding tube is working and is still correctly placed. Then you go ahead and push the water into the tube. After this, unscrew the syringe and screw in the syringe that you have filled with the food an proceed with the feeding. After that, just flush with a little water to wash all the food from the tube.
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This is all GREAT. Thanks so much. This is making me feel more positive today, along with sleeping and no longer feeling overwhelming responsibility and failure watching her deteriorate.

She is eating for them, which is good. I think the tube, for her, is primarily to help get her home and reduce chance of relapse because it's such a spiral. From what I remember of the vet call yesterday, basically everything she has going on will affect her appetite. I am quite excited about this being a way to get meds in her, too. I will push for a demo.

JaxBenji said:
think we had instructions to use carbonated water
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I saw coca cola mentioned??
 
Suzanne & Darcy said:
Oh boy. I have a lot of sick kitty experience for sure! Ugh! Just today I've been at the vet with a kitten we just rescued. Poor thing had been injured somehow, had developed an abscess that burst. I left her at the vet this morning. Turns out that she had a bunch of maggots in there (I knew she smelled bad). Vet had to anesthetize her, clean it all out, etc. Poor baby.
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Oh. My. Goodness. speechless on that one. How many kitties do you have???

Oooh and does she also get an Austen name? Or something from Bridgerton instead maybe? :cat:
 
The ER vet tech who showed me how to do all this was really nice. They gave me all the supplies I needed. She definitely wanted me to check the "stoma" (incision/opening) site daily. I have to admit that, after about two weeks I was only checking it about every other day. Like I said, it was just barely hanging in there when they removed it. He was having a dental tooth extraction that day, so we removed tube at the same time while he was under (but normally, you do NOT have to have them asleep while you do the removal).
 
Liz & Minnie said:
This is all GREAT. Thanks so much. This is making me feel more positive today, along with sleeping and no longer feeling overwhelming responsibility and failure watching her deteriorate.

She is eating for them, which is good. I think the tube, for her, is primarily to help get her home and reduce chance of relapse because it's such a spiral. From what I remember of the vet call yesterday, basically everything she has going on will affect her appetite. I am quite excited about this being a way to get meds in her, too. I will push for a demo.

I saw coc
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I heard something about using coca cola if it became blocked?? I've never done this. Think of what the BGs would do on coca cola! Wow!
 
I would do it if she is stable enough to undergo a short anesthesia. You can get all the food and meds into her without a fight and she will be able to get stronger. If she has a "bad day" it won't spiral out of control. It gives her a much better chance.
 
Suzanne & Darcy said:
I would do it if she is stable enough to undergo a short anesthesia. You can get all the food and meds into her without a fight and she will be able to get stronger. If she has a "bad day" it won't spiral out of control. It gives her a much better chance.
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THANK YOU!! I am CONVINCED! :)
 
Liz & Minnie said:
Oh. My. Goodness. speechless on that one. How many kitties do you have???

Oooh and does she also get an Austen name? Or something from Bridgerton instead maybe? :cat:
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That information is available on a "need to know" basis. It is a strictly guarded national security secret and varies depending on who is asking and when they are asking! :smuggrin:

Right now this rescued kitten has no name. It is the tiniest thing I've ever seen. I know that she is like 10 months old but she's only about 3.4 lbs. I can't figure it out. A runt? She's a very sweet thing. I'm toying with Tinkerbell.
 
Suzanne & Darcy said:
Argh. Still trying post a photo
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Awwhhh bless him. He looks so calm and relaxed there. He's got a lovely coat! He is so lucky to have you, what excellent care you give. (I just checked his s/s...waiting on tenterhooks for that blue. He is taunting us with that last reading)
 
Suzanne & Darcy said:
That information is available on a "need to know" basis. It is a strictly guarded national security secret and varies depending on who is asking and when they are asking! :smuggrin:

Right now this rescued kitten has no name. It is the tiniest thing I've ever seen. I know that she is like 10 months old but she's only about 3.4 lbs. I can't figure it out. A runt? She's a very sweet thing. I'm toying with Tinkerbell.
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Tinkerbell is a lovely name for a little girlie! Though it is definitely not Austen.
 
JaxBenji said:
you are so welcome - and please look at him in that pic and in my profile pic. He was so sick in that feeding tube picture...I think 9ish pounds...in my profile pic, he is 14.2 (his "regular" weight). Happy to help :bighug:
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Such a handsome boy. What I like about the feeding tube picture is that he is eating. Nothing like watching a cat refuse food to make you really appreciate when they eat. Hope you are doing ok. :bighug:
 
My Charlie had feeding tubes three different times. They truly can be life savers. It’s jolting to her the term “feeding tube” but the perception is often worse than reality. Just like learning anything new, once you get the hang of it, it’s not so bad.

Sounds like you’ve done a good bit of reading and have a better handle on it now, but please ask questions if you have any. Hopefully the vet will give you a demo — seeing it firsthand can instill confidence.

Key points when Charlie had his feeding tubes:
* flush the tube with a bit of lukewarm water both before and after feeding (so tube doesn’t get clogged)
* syringe the allotted amount of food slowly (take breaks, be patient) to avoid vomiting/regurgitation and food backing up in the tube. I set up a low-profile box with a pillow/blanket for Charlie to relax on, then sat with him on my lap and watched TV while feeding. I used a 30-minute program as a guide for how long to stretch out the feeding.
* Gently clean the stoma site daily
* Warm the food slightly before feeding (test it on your wrist like you would baby formula)
* have all of your supplies ready and handy before you start, including the food, water for flushing the tube, supplies for cleaning the stoma site, a wet washcloth or baby wipes, the feeding syringe, tape or whatever is used to re-secure the tube to the cat’s body when done, and an extra small cup of warm water to rinse the syringe after drawing food into it (helps prevent a mess, especially if you draw food multiple times in a session).

I’d also recommend a pill crusher if you don’t have one.

There’s more, I’m sure, but that’s just off the top of my head. Charlie chilled and didn’t mind the process at all. The first few times can be daunting but I have no doubt you can work out any glitches and will be a pro in no time.
 
Good luck with the feeding tube. :bighug::bighug::bighug: I hope it'll make things a lot less stressful for you. I can think of one or two others with experience if you still want to hear more.

Keeping Minnie in my thoughts.
 
I haven’t had experience with cats and tube feeding, although I have read of positive experiences here on the forum, but I have tubefed plenty of babies and some adults and it is much easier on the patient and the CG than it is to try and get them to eat if they are having trouble with eating.
And it saves a lot of energy and stress for the patient (and the CG). They just have to sit or lie there.
Good luck with it :bighug:
 
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